With regards to the application of...

Name of the prospective student.

The Family Education Rights and Privacy Act of 1974 permits students the right to inspect their files. Because of the importance of preserving the confidentiality of a reference, the Act permits an applicant to waive his right of access to the reference. By requesting this reference, the applicant willingly waives his/her right of access to see this recommendation knowing that this waiver is NOT required as a condition for admission.

Note: Data Protection Act 1998 (UK) Personal details supplied will only be used for the purposes of the "Discipleship Experience" program and will not be divulged to any third party. Furthermore this data will be securely disposed of at the termination of the program.

Your personal details

Complete personal details help us to be sure of an authentic reference. Your personal details will not be passed to any third party at any time.

Full Name

First Name Last Name

E-mail

Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Phone Number

-
Area Code Phone Number

Your ministry details

Church/Organization you belong.

Your position

Your relationship with the applicant

How long have you known the applicant?

How long has the applicant been an active Christian?

In what capacity have you known the applicant?

Your spiritual insights

Does this applicant display a commitment/desire to be a follower of Christ?

Yes No Sometimes

Can you please give a brief example.

Do you feel God has given this applicant any particular gifts or ministries?

Yes No Not sure

Which gifts or ministries do you feel God has given this applicant?

Do you have any concerns about this applicant that would assist us when considering their application?

Yes No

Please share your concerns.

Character assesment

Please use the scale below to help give us a better understanding of the applicants character. If you are not in a position to give a good assesment on any of the points below then please leave a blank where appropriate.

Responsibility

1

2

3

4

5

6

7

8

9

10

Worst

Best

Adaptability

1

2

3

4

5

6

7

8

9

10

Worst

Best

Cooperation/Teamwork

1

2

3

4

5

6

7

8

9

10

Worst

Best

Communication

1

2

3

4

5

6

7

8

9

10

Worst

Best

Spiritual Maturity

1

2

3

4

5

6

7

8

9

10

Worst

Best

Church Involvement

1

2

3

4

5

6

7

8

9

10

Worst

Best

Emotional Stability

1

2

3

4

5

6

7

8

9

10

Worst

Best

Personal Recommendation

1

2

3

4

5

6

7

8

9

10

Worst

Best

Thank you for taking the time to fill out this reference. Please click on the submit button below to send the form directly to our office.